Provider Demographics
NPI:1114265196
Name:EVOLUTION HOME HEALTH AND TRANSPORTATION
Entity Type:Organization
Organization Name:EVOLUTION HOME HEALTH AND TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVON
Authorized Official - Middle Name:
Authorized Official - Last Name:LITTLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-794-8359
Mailing Address - Street 1:PO BOX 37348
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-0348
Mailing Address - Country:US
Mailing Address - Phone:248-794-8359
Mailing Address - Fax:313-270-7025
Practice Address - Street 1:16855 WILDEMERE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48221-3162
Practice Address - Country:US
Practice Address - Phone:248-794-8359
Practice Address - Fax:313-270-7025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-24
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health